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South Nassau in the Community

04/02/2009

Cataract Surgery Results Improved by New Lens

Cataract surgery is one of the safest and most effective surgeries performed in the United States. According to the National Institutes of Health, approximately 95 percent of all cataract surgeries result in improved vision.

But that’s not good enough at South Nassau Communities Hospital. Its ophthalmologists are implanting an acrylic, single-piece toric intraocular lens (IOL) that reduces or eliminates astigmatism and significantly improves uncorrected distance vision. Astigmatism is caused by an irregular or toric curvature of the cornea resulting in blurry vision due to the inability of the optics of the eye to focus a point object into a sharp focused image on the retina.
Many patients with advanced astigmatism still need glasses for near and distance vision following cataract surgery. Some, however, will opt for limbal relaxing incisions (LRI, also known as astigmatic keratotomy). LRIs correct mild astigmatism and are made during cataract surgery. They are inserted at the boundary (limbus) of the eye, separating the cornea from the white of the eye (sclera), flattening and rounding the curvature of the eye's clear surface (cornea) and reducing the level of astigmatism.

“The implant is specifically designed for astigmatism correction, eliminating the need for additional LRIs in most cases,” said Richard Nauheim, MD, Director of Ophthalmology. “Implanting the toric lens in patients with significant astigmatism will reduce the surgical steps needed to achieve the same amount of vision correction.”

According to Dr. Nauheim, the new lens also offers an enhanced aspheric optic that improves image quality and increases contrast sensitivity in cataract surgery patients with astigmatism.

The lens, along with advancements such as a micro-incision system that requires a single incision of 2.2mm or smaller to perform cataract surgery and a surgical system that offers three different surgical options, allows South Nassau’s ophthalmologists to develop surgical approaches that are tailored to the needs of each patient.

“The lens is just another example of our enduring commitment to use the advanced surgical technologies to improve patient outcomes, safety, and recovery time after surgery,” said Dr. Nauheim. “We are determined to provide our patients with the surgical options that will ensure that they experience all the benefits promised by surgery.”

A cataract is a clouding of the eye's lens, which is located behind the iris (the colored part of the eye) and the pupil (the round opening in the center of the iris). The lens is mostly made of water and protein, which combine to keep the lens clear, allowing light to pass through it. With aging, some of the protein may clump together, forming a cataract, which clouds an area of the lens. Cataracts are a leading cause of vision loss in adults age 55 and older. By age 65, about half of the human population has a cataract, and by age 75, almost everyone has a cataract.

Cataract surgery takes approximately 20 minutes and requires a tiny incision in the cornea that serves as a portal to insert an ultrasonic tip. Vibrating at thousands of times per second, the ultrasonic tip breaks up the cataract-clouded lens. The fragments of the lens are removed by suction through a small hole in the tip of the probe. After the lens is removed, an intraocular lens (also referred to as an IOL, which is an artificial lens made of plastic or acrylic that replaces the eye's natural lens) is placed into the eye through the same incision and set into the same position as the natural lens, restoring the eye’s ability to focus.